Concern for Adults 40-60

Saliva, or spit, plays a significant role in maintaining oral health.Like blood,
saliva helps build and maintain the health of soft and hard tissues. When saliva
flow is reduced oral health problems such as tooth decay and other oral infections
can occur. Chewing is the most efficient way to stimulate salivary flow. It causes
muscles to compress the salivary glands and release saliva.

Saliva washes away food and debris from teeth and gums.

Helps moisten and break down food to ease swallowing and enhances ability to taste.

Provides disease-fighting substances throughout your mouth to help prevent cavities
and other infections.

Helps keep the surface of your teeth strong by providing high levels of calcium,
fluoride and phosphate ions at the tooth surface.

In addition to keeping your mouth healthy, saliva may contain indicators of health
concerns as well. Since it shares many properties with blood, the use of saliva
to detect and diagnose oral diseases and other diseases that could affect your general
health is being studied. Researchers have reported promising results in the use
of saliva for the diagnosis of breast cancer, oral cancers, gum disease and viral
hepatitis. Saliva is already used for rapid HIV testing.

We all suffer from a dry mouth from time to time, but for some people the condition
is more long- lasting.

Xerostomia is a condition where the mouth becomes very dry and can make people more
susceptible to dental problems such as tooth decay or cause problems for denture
wearers.

There are lots of different reasons why people get dry mouth, and there are things
that you can do both to ease the condition and help prevent problems with your teeth.

Some prescription drugs and medicines can cause dry mouth as a side effect, especially
treatments for depression and high blood pressure,and cancer. Also, certain medical
conditions like diabetes affect the salivary glands, so they don't produce as much
saliva and the mouth tends to be dryer.

Xerostomia can lead to a burning or sore feeling in the mouth or a bad taste. You
may also have difficulty swallowing and speaking. If you wear dentures, you may
find they become loose and cause sore areas.

Making sure you don't get dehydrated . Drinking plenty of fluids can help. Also,
doctors can prescribe artificial saliva which comes as a spray to help moisten the
mouth. The IDA recommends that you talk to your doctor about the medicines you take
to see if there are suitable alternatives less likely to cause dry mouth. Some people
find sucking sweets, or chewing gum helps produce more saliva, but take special
care that these don't contain sugar as this could cause more tooth decay.

We all snore from time to time, usually if we're nursing a cold or a blocked nose.
For some people, though, snoring is a long term condition which can be distressing
for them and their partners. In these cases, dentists may be able to help.

Snoring happens when the soft palate and soft tissues in the throat vibrate together.
Throat muscles relax during sleep, like all muscles, and this reduces the size of
the airway. A dentist may be able to fit a special appliance which can be worn in
the mouth to pull the lower jaw and tongue forward, keeping the airway open and
reducing the chance of snoring.

How to prevent snoring

Cut back on alcohol or sedatives and stop smoking if any.

Try losing weight.

Change your sleeping position.

Ask your dentist about special appliances to open up the airway.

Ask your doctor or pharmacist about drugs to reduce nasal congestion.

Snoring may indicate an underlying medical conditions,so it is advisable to rule
those out too.

If you realize you have a snoring problem,ask your dentist for a solution.

Sleep apnea is a common and serious sleeping disorder that happens when your regular
breathing is interrupted during sleep. Snoring is common among patients with sleep
apnea but not all snorers have sleep apnea.

There are two main types of sleep apnea:

1: Obstructive sleep apnea. The more common form, it is the result of blocked airflow
during sleep, usually when the soft tissue at the back of the throat collapses while
you sleep. Health factors, such as obesity may contribute.

2: Central sleep apnea.

Results from a problem with how the brain signals the breathing muscles. The airway
is not blocked, instead the brain fails to signal the muscles to breath. This type
of sleep apnea can occur with conditions such as heart failure, brain tumors, brain
infections, and stroke.

Sleep apnea can affect any one at any age, although men are more likely to develop
the disorder. The risk is also greater for those:

Over 40

Overweight

With large tonsils, large tongue or small jaw

With a family history of sleep apnea

With a nasal obstruction due to a deviated septum, allergies or sinus problems.

If left untreated, sleep apnea can result in a number of health problems including:

High blood pressure

Stroke

Heart failure, irregular heartbeat and heart attack

Diabetes

Depression

Worsening of ADHD.

Sleep apnea can be treated.

There are several options:

Adjusting sleeping habits. This may mean simply not sleeping on your back

Continuous positive air pressure (CPAP). This is a device which improves breathing
while you sleep. The device supplies air through the nasal passages and the air
pressure keeps the airway open while sleeping.

Oral appliances. Certain oral devices can shift and support the jaw to prevent the
airway from collapsing. Research shows that oral appliances can successfully prevent
sleep apnea in some mild to moderate cases.

According to the American Academy of Dental Sleep Medicine, upper airway surgery
may be recommended when other treatment options are unsuccessful in eliminating
the symptoms of sleep apnea. Depending on the location and nature of the airway
obstruction, the procedure may be minimally invasive or more complex. It may be
necessary to remove the tonsils or other parts of the soft palate or throat.

The IDA recommends that if you think you have sleep apnea, make sure to speak with
your physician or dentist for more information and possible evaluation.

Gum disease is caused by plaque, just like tooth decay. If the plaque isn't removed
with brushing, flossing or a mouth rinse, it can get under the gum line and attack
the gums, making them red and puffy. You may also notice some bleeding when you
brush your teeth.

If left, gum disease can cause serious problems. The gum may start to loosen creating
'pockets' around the teeth where even more plaque can gather. Over time, the plaque
will begin eating away at the bone that supports the tooth, which may mean you have
to have that tooth removed.

Types of gum diseases:

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become
red, swollen, and bleed easily. There is usually little or no discomfort at this
stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible
with professional treatment and good oral home care.

Periodontitis

Untreated gingivitis can advance to periodontitis. With time, plaque can spread
and grow below the gum line.Gums separate from the teeth, forming pockets (spaces
between the teeth and gums) that become infected. As the disease progresses, the
pockets deepen and more gum tissue and bone are destroyed.

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis occurs in patients who are otherwise clinically
healthy. Common features include rapid attachment loss and bone destruction and
familial aggregation.

Chronic periodontitis This is the most frequently occurring
form of periodontitis and is characterized by pocket formation and/or recession
of the gingiva. It is prevalent in adults, but can occur at any age. Progression
of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases often begins
at a young age. Systemic conditions such as heart disease, respiratory disease,
and diabetes are associated with this form of periodontitis.

Necrotizing periodontal disease is an infection characterized by
necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions
are most commonly observed in individuals with systemic conditions such as HIV infection,
malnutrition and immunosuppression.

Gum disease is very common in India, with most adults suffering some form of it,
but it is very simple to prevent.

Here are some top tips:

Brush your teeth twice a day using a fluoride toothpaste. Make sure you pay special
attention to the gum line too.

Stop smoking. It makes gum disease even worse.

The IDA recommends that you visit your dentist regularly. They will be able to spot
gum disease early on and give you advice on how best to brush your teeth and the
best way to floss.

Both crowns and most bridges are fixed prosthetic devices. A crown is used to entirely
cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can
be used to improve its appearance, shape or alignment. A crown can also be placed
on top of an implant to provide a tooth-like shape and structure for function. Porcelain
or ceramic crowns can be matched to the color of your natural teeth. Other materials
include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger
than porcelain and may be recommended for back teeth. Porcelain bonded to a metal
shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

Replace a large filling when there isn't enough tooth remaining

Protect a weak tooth from fracturing

Restore a fractured tooth

Attach a bridge

Cover a dental implant

Cover a discolored or poorly shaped tooth

Cover a tooth that has had root canal treatment

Bridges are a series of joint crowns used to replace missing tooth/teeth.

How are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced
in size so that the crown or bridge will fit over it properly. After reducing the
tooth/teeth, your dentist will take an impression to provide an exact mold for the
crown or bridge. If porcelain is to be used, your dentist will determine the correct
shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material
your dentist specifies. A temporary crown or bridge will be put in place to cover
the prepared tooth while the permanent crown or bridge is being made. When the permanent
crown or bridge is ready, the temporary crown or bridge is removed, and the new
crown or bridge is cemented over your prepared tooth or teeth.

Crowns

Full porcelain fused to metal.

Full cast gold crown.

Bridges

Teeth around the missing tooth are prepared.

The bridge is tried in the mouth.

The bridge is cemented.

Once cemented these crowns and bridges do not need any special maintenance or care
other than routine maintenance of oral hygiene .These are strong enough to withstand
normal biting pressures and are long lasting.

Removable dentures are one of the most common ways of replacing missing teeth. Dentures
can replace either a few teeth - a partial denture - or a whole set - complete dentures.
Removable partial dentures usually consist of replacement teeth attached to pink
or gum-colored plastic bases. Depending on your needs, your dentist will design
a partial denture for you. A partial denture may have a metal framework and clasps
that connect to your teeth, or they can have other connectors that are more natural
looking. In some cases, a removable partial denture is made to attach to your natural
teeth with devices called precision attachments. Precision attachments are generally
more esthetic than clasps.

Crowns on your natural teeth are sometimes needed to improve the fit of a removable
partial denture and they are usually required with attachments. Partial dentures
with precision attachments generally cost more than those with clasps. Consult your
dentist to find out which type is right for you.

With newer materials and techniques,the removable dentures have become much more
convenient to use.They are lighter,stronger and more aesthetic than they used to
be a couple of years back,besides being one of the most cost effective ways of teeth
replacement.

Cleaning your dentures

If you have dentures, it's important to keep them clean. Looking after them can
be much easier than looking after your natural teeth, as you can take them out and
have a good look to make sure you haven't left any old food behind.

To give them the best clean, follow these simple tips:

Clean your denture over a basin of water - then, if you drop it, it's unlikely to
get damaged.

Make sure you brush your denture every day, just as you would your own teeth. You
should use a soft to medium brush - which won't scratch the denture - with soap
and water. Make sure you rinse it before putting it back in your mouth.

You can also soak your denture using a special solution or tablets. Remember, though,
that you will still need to brush the denture to make sure it's really clean. Again,
you'll need to rinse it before putting it back in your mouth.

Dental implants are one way of replacing missing teeth. The way they are mounted
onto posts and inserted into the jaw during surgery means that they look and feel
just like natural teeth.

Although there are many advantages to having implants, they are not suitable for
everyone. You need to have healthy gums and be in good general health. You also
need enough jawbone to take the posts and support the replacement teeth. Some chronic
diseases, such as diabetes, osteoporosis or chronic sinus problems could interfere
with healing and make implants more likely to fail.

If you choose to have implants, you will undergo surgery twice or more over a period
of several months.

The dentist will expose the bone in the jaw where the tooth is missing. Then he
will drill a hole and insert a metal post into the bone. This is usually done under
a local anaesthetic. The gum is then stitched over the post and it's left to heal
for several months, while the bone grows around the post, making it secure.

After this period, there will be second operation, in which replacement teeth are
mounted onto the metal post. This requires a small cut in the gum above the implant.
The replacement teeth might be single or in a group, and possibly as a 'bridge',
attached to neighbouring natural teeth. They may be fixed permanently or attached
in a way that lets you remove them for cleaning.

Immediate placement

An increasingly common strategy to preserve bone and reduce treatment time includes
the placement of a dental implant into a recent extraction site. It shortens treatment
time and can improve esthetics because the soft tissue envelope is preserved.Its
best to let the dentist decide whether you are a candidate for immediate placement
or not.

The IDA recommends that after surgery, it's absolutely essential to maintain good
mouth hygiene and visit your dentist regularly.

Immediate post-operative risks

Infection

Excessive bleeding

Flap breakdown

There are many advantages to dental implants, including:

Improved appearance. Dental implants look and feel like your own teeth. And because
they are designed to fuse with bone, they become permanent.

Improved speech. With poor-fitting dentures, the teeth can slip within the mouth
causing you to mumble or slur your words. Dental implants allow you to speak without
the worry that teeth might slip.

Improved comfort. Because they become part of you, implants eliminate the discomfort
of removable dentures.

Easier eating. Sliding dentures can make chewing difficult. Dental implants function
like your own teeth, allowing you to eat your favorite foods with confidence and
without pain.

Improved self-esteem. Dental implants can give you back your smile and help you
feel better about yourself.

Improved oral health. Dental implants don't require reducing other teeth, as a tooth-supported
bridge does. Because nearby teeth are not altered to support the implant, more of
your own teeth are left intact, improving long-term oral health. Individual implants
also allow easier access between teeth, improving oral hygiene.

Implants are very durable and will last many years. With good care, many implants
last a lifetime.

Removable dentures are just that; removable. Dental implants eliminate the embarrassing
inconvenience of removing dentures, as well as the need for messy adhesives to keep
them in place.

A group of mutant cells that migrate and invade other parts of the body through
blood and lymph.

Manifestation of the disease in the form of a tumour, which is a group of mutant
cells that form a tissue.

Risk to all, regardless of gender or age.

A cause that is multi-factorial and where the disease process differs at different
sites.

Ororpharyngeal cancer can affect any area of the oropharyngeal cavity including
the lips, gum tissue, check lining, tongue, jaw the hard or soft palate and throat.
It often starts as a tiny, unnoticed white or red spot or sore or swelling anywhere
in the mouth or throat.

The symptoms of mouth or throat cancer can include:

Sores that bleed easily or do not heal

A thick or hard spot or lump

A roughened or crusted area

Numbness, pain or tenderness

A change in the way your teeth fit together when you bite down.

Make sure to tell your dentist about any problems you have when chewing, swallowing,
speaking or moving your tongue or jaw. Regular dental check- ups, including an examination
of the entire mouth, are essential in the early detection of cancerous and pre-
cancerous conditions.

The following are risk factors for oral cancer:

Tobacco: Tobacco use accounts for most oral cancers. Smoking cigarettes,
cigars, or pipes; using chewing tobacco; and dipping snuff are all linked to oral
cancer. The use of other tobacco products (such as bidis ) may also increase the
risk of oral cancer. Heavy smokers who use tobacco for a long time are most at risk.
The risk is even higher for tobacco users who drink alcohol heavily. In fact, three
out of four oral cancers occur in people who use alcohol, tobacco, or both alcohol
and tobacco.

Alcohol: People who drink alcohol are more likely to develop oral
cancer than people who don't drink. The risk increases with the amount of alcohol
that a person consumes. The risk increases even more if the person both drinks alcohol
and uses tobacco.

Sun: Cancer of the lip can be caused by exposure to the sun. Using
a lotion or lip balm that has a sunscreen can reduce the risk. Wearing a hat with
a brim can also block the sun's harmful rays. The risk of cancer of the lip increases
if the person also smokes.

During your dental visit, your dentist can talk to you about your health history
and examine these areas for signs of mouth and/or throat cancer.

The IDA recommends that regular visits to your dentist can improve the chances that
any suspicious changes in your oral health will be caught early, at a time when
cancer can be treated more easily. Consult your dentist regularly if you have a
high risk lifestyle.

Diabetes is a chronic disease which affects your body’s ability to process
sugar. The resulting high blood sugar can cause problems with your eyes, nerves,
kidneys, heart and other parts of your body. Diabetes can lower your resistance
to infection and can slow the healing process.

If you have diabetes, you are at greater risk of developing some oral health problems.
The most common oral health problems associated with diabetes are:

Gum disease:Recent research suggests that the connection between gum disease
and diabetes goes both ways. On the one hand, because of lowered resistance and
a longer healing process, gum disease appears to be more frequent and more severe
among those with diabetes. Conversely, it appears that treating gum disease in people
with diabetes can help improve blood sugar control.

Fungal infections.: Since diabetes compromises your immune system, you may
be prone to developing fungal infections. Symptoms include painful sores and difficulty
swallowing. If you develop a fungal infection, see your dentist.

Infection and delayed healing:If you are having extensive oral surgery, your
dentist may prescribe antibiotics to minimize the risk of infection. To help the
healing process, keep your blood glucose levels under control before, during and
after surgery.

If you are a diabetic,make sure you inform your dentist prior to treatment. Regular
dental visits are a must for a person suffering from diabetes.